Format

Send to

Choose Destination
See comment in PubMed Commons below
J Am Geriatr Soc. 2001 Apr;49(4):351-9.

A randomized clinical trial of outpatient geriatric evaluation and management.

Author information

1
Department of Family Practice and Community Health, University of Minnesota School of Public Health, Minneapolis, USA.

Abstract

OBJECTIVES:

To measure the effects of outpatient geriatric evaluation and management (GEM) on high-risk older persons' functional ability and use of health services.

DESIGN:

Randomized clinical trial.

SETTING:

Ambulatory clinic in a community hospital.

PARTICIPANTS:

A population-based sample of community-dwelling Medicare beneficiaries age 70 and older who were at high risk for hospital admission in the future (N = 568).

INTERVENTION:

Comprehensive assessment followed by interdisciplinary primary care.

MEASUREMENTS:

Functional ability, restricted activity days, bed disability days, depressive symptoms, mortality, Medicare payments, and use of health services. Interviewers were blinded to participants' group status.

RESULTS:

Intention-to-treat analysis showed that the experimental participants were significantly less likely than the controls to lose functional ability (adjusted odds ratio (aOR) = 0.67, 95% confidence interval (CI) = 0.47-0.99), to experience increased health-related restrictions in their daily activities (aOR = 0.60, 95% CI = 0.37-0.96), to have possible depression (aOR = 0.44, 95% CI = 0.20-0.94), or to use home healthcare services (aOR = 0.60, 95% CI = 0.37-0.92) during the 12 to 18 months after randomization. Mortality, use of most health services, and total Medicare payments did not differ significantly between the two groups. The intervention cost $1,350 per person.

CONCLUSION:

Targeted outpatient GEM slows functional decline.

PMID:
11347776
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center